Infertility Workup

 
 

Infertility Workup

A. Testing Ovulation Function

Note – you will not need a “test” of ovulation function if you do NOT have periods at all or only have a period if induced with prescription progesterone. In such cases, we skip to “additional” tests below.

Blood progesterone level
Drawn 5-7 days after ovulation
You do NOT need an office appointment to come in and have your blood drawn, but call 770-751-3600 to schedule the blood “draw” (or go online at https://secure.awhg.org/rosobgyn to schedule it directly)

You must be certain of your ovulation timing for a blood progesterone level to be interpretable. Please use an ovulation test kit or a basal body temperature graph if you are not entirely sure of your ovulation. Additional Testing: If you do not ovulate or if your progesterone level is found to be low, we will recommend some or all of the following tests:
TSH (thyroid stimulating hormone) – drawn any cycle day
Fasting prolactin – drawn any cycle day
Fasting glucose and insulin – drawn any cycle day
HgbA1C – if not fasting (instead of the glucose and insulin)
AMH – drawn any cycle day
FSH (follicle stimulating hormone) – drawn on cycle day 2 or 3
Estradiol – drawn on cycle day 2 or 3

B. Testing Tubal Patency

There is only one basic test of tubal patency, a hysterosalpingogram or HSG. An HSG is an X-ray of your fallopian tubes and uterine cavity performed in a radiology department (outpatient or at a hospital). An HSG is typically done between cycle days 7-11 but could be done sooner if you have short cycles.
To schedule your HSG call Tamara Sanders (770 544-2305), Ann Hooper (770-255-2549), or Andrea White (770 544-2226) after your period begins. They will go over additional details.

C. Testing For Male Factor Problems

The initial screening test is a semen analysis (SA) – The ICD-9 is Z31.41. Your partner needs to ejaculate into a specimen cup at home and get the specimen to the lab (at room temperature) within an hour. He needs to abstain from ejaculating for 2-3 days prior to the collection.

I recommend you take the specimen to one of the reproductive endocrine practices (RBA, ACRM, GRS, or Emory – see web links for locations). For your convenience these practices have both main offices and satellite offices. The satellite offices may not be able to handle a semen specimen 5 days a week, so please call the actual location you’re going to use to confirm they’ll be able to run the test.

RBA – http://www.rba-online.com/
ACRM – http://www.acrm.com/
GRS – http://www.ivf.com/
Emory – http://www.emoryhealthcare.org/reproductive-center/